Baltimore police have a duty to carry naloxone [Commentary]

By Nina Miller

In March, Anne Arundel County was the first county in Maryland to put the powerful, lifesaving drug naloxone in the hands of its police officers. Naloxone is a safe and effective prescription medicine that reverses an opioid overdose. It can be administered via a simple nasal spray device. Emergency medical professionals have used it for decades, and recently more and more police departments across the country are equipping their officers with the skills and supplies necessary to administer this lifesaving treatment to people suffering from an opioid overdose. Police are often the first to arrive at the scene of an overdose, and those early minutes can be the key to saving a life. Given the magnitude of heroin abuse in Baltimore City, the Baltimore police department should be the next to initiate this type of program.

Opiate addiction, including heroin abuse, has long been a pervasive public health problem in Baltimore City. Baltimore is known as the "heroin capital" of the United States, and for good reason. A 2000 report by the Drug Enforcement Agency determined that Baltimore had the highest per capita rates for heroin use in the country. More recently, the statistics were updated in a 2009 report claiming that roughly 60,000 people in the city were addicted to heroin. This equate to a staggering 1 out of 10 Baltimore residents.

Saving the life of a heroin addict brings with it a responsibility to have a followup plan to prevent another overdose. Simply bringing these addicts back from the brink so that they live for their next hit is senseless. Dropping them into 30 day programs, with no hope at the end of that time...

The effects of heroin abuse are disastrous. Heroin and other opiates, including prescription painkillers, are extremely addictive. Accidental overdoses cause depressed breathing that can lead to unconsciousness and death. In Maryland, heroin-related deaths have been increasing at an alarming rate. The state recorded 238 deaths in 2010 and 245 in 2011. That number jumped to 378 in 2012 and is expected to be even higher in the 2013 statistics, which aren't yet available. The recent trend of lacing heroin with another strong opiate, fentanyl, has made the threat of overdosing even greater. Fentanyl is a very potent opiate, meaning users who think they are buying regular heroin and shoot up with the same amount as usual can suffer fatal consequences.

Law enforcement naloxone programs have proven to be very successful in saving lives. The first program in the country, launched by the Quincy, Mass., police department, has saved 230 lives in four years. In addition to saving lives, an important effect of these programs is a much-needed change in the relationship between drug users and law enforcement. By giving law enforcement the means to save a drug user's life, a shift occurs in officers' attitudes from a focus on arresting and jailing drug users to a focus on the value of all human life. In Quincy, the lieutenant who initiated the program has said some drug users now actively seek out police when an overdose occurs. Trust and understanding between users and police is an important part of the fight against drug abuse and addiction issues.

While providing police officers with naloxone is an important step toward saving lives of those affected by drug addiction, it is not the be all, end all. Expanding programs that distribute naloxone directly to drug users and their loved ones can provide a wider, more accessible safety net. Last year, Maryland lawmakers passed a law creating a statewide program to give naloxone to relatives of addicts. Thirteen districts including Baltimore are splitting the funding to set up training programs with a goal to train at least 1,000 people to use naloxone this year.

Given the degree to which heroin abuse plagues the city of Baltimore, it is a public responsibility to protect the lives of those in danger and offer resources to help those who seek it. Anne Arundel County has set the precedent for police departments in Maryland to follow. It is time for Baltimore police to step up and take action in the fight against heroin overdose deaths.

Dr. Nina Miller is a resident within the Johns Hopkins General Preventive Medicine Residency. Her email is nmille44@jhu.edu.

Anne Arundel County has seen heroin overdoses at a rate of more than one a day so far in 2014, and on Monday officials said they're putting a powerful drug in the hands of police officers in hopes of saving lives.

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